ARYA Atherosclerosis Journal

A case report of chordal systolic anterior motion without hypertrophic cardiomyopathy misdiagnosed with acute coronary syndrome

Document Type : Case Report

Authors

Mohammad Haji Aghajani 1
Fateme Omidi 2
Reza Hamneshin Behbahani 1
Moein Ebrahimi 3

1 Department of Cardiology, School of Medicine, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Clinical Research Development Center, Imam Hossein Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

https://doi.org/10.48305/arya.2024.42681.2967
Abstract
Chordal systolic anterior motion (SAM) refers to the anterior motion of the mitral valve towards the left ventricular outflow tract (LVOT) that occurs during systole. Chordal SAM is a potentially fatal condition. Chordal SAM is linked to an elevated risk of sudden death and can lead to significant obstruction of the left ventricular outflow tract (LVOT) and mitral regurgitation. It is crucial to acknowledge and consider this phenomenon when assessing individuals experiencing dyspnea and chest discomfort. By doing so, unnecessary therapies related to heart failure and heart attack might be avoided. Ensuring timely diagnosis is crucial in order to prevent unnecessary and potentially dangerous therapies that can aggravate LVOT obstruction and lead to hemodynamic instability. In this paper, we present a 47-year-old woman who experienced sudden chest pain and dyspnea. The patient had a history of hypertension and previous myocardial infarction. ST-elevation was observed in the first ECG. The primary treatment for acute coronary syndrome was initiated. Coronary angiography demonstrated that coronary vessels were not obstructed. The diagnosis of chordal SAM was initially overlooked during the echocardiography, but it was later identified during a subsequent echocardiography after cardiac catheterization. When using beta-blockers, her clinical condition improved.

Keywords

Chordal Systolic Anterior Motion
Valvular Systolic Anterior Motion
Diuretic
LVOT Obstruction
Hypertrophic Cardiomyopathy
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ARYA Atherosclerosis Journal
Volume 20, Issue 6
November and December 2024
Pages 1-5

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